PROJECT SUMMARY - In the early 1960's, asthma in Native American populations was still relatively rare. Since then, it has become increasingly prevalent in Indian children under 15 years of age. Despite the fact that many live in rural locations, morbidity and mortality rates of asthma among American Indians are nearly the same as rates seen among all races in the United States. While the reasons for this increase are not yet clear due to a lack of epidemiologic data on asthma in Native communities, among the potential environmental health risks are increases in exposure to mainstream and side-stream tobacco smoke, the use of wood-burning stoves, a high incidence of attacks of respiratory viruses in infants, and co-morbidity of asthma with obesity. In the social environment, many American Indians are living in conditions of extreme poverty, with high unemployment and lower educational attainment, adding further weight to the physical and financial burdens of childhood asthma on these communities. This project will conduct a regional conference on asthma designed to inform representatives of Northern Plains tribal health agencies about the current state of knowledge, research, and treatment of asthma, its potential environmental health triggers, prevention strategies, and environmental improvement measures. The goal of this project is to advance the state of knowledge of asthma among tribal health representatives and directors, Indian Health Service staff, emergency medical workers, nurses, and pediatricians working with 18 tribes in the region served by the Northern Plains Tribal Epidemiology Center (IA, NE, ND, SD) so that they may transform this knowledge into better medical services and heightened understanding of this condition in their communities. The workshop will be held in September 2006 at the Alex Johnson Hotel in Rapid City, SD. It will address exposures to everyday types of indoor and outdoor contaminants, including, but not limited to environmental tobacco smoke, allergens and endotoxins, molds and insects, biological contaminants such as dust mites, chemical contaminants such as pesticides and formaldehyde, exhaust from wood-burning stoves, and motor vehicle exhaust. The EHSRC and its investigators at The University of Iowa are uniquely qualified to carry out this dissemination conference, as it is the only NIEHS-funded center to focus on rural environmental exposures with specialization in asthma research.